Microscopic colitis: a guide for general practice.

Abstract

Irritable bowel syndrome (IBS) affects 10%–20% of the population1 but other conditions have similar symptoms. Microscopic colitis is a cause of chronic, non-bloody, watery diarrhoea, particularly in older patients in whom the impact on quality of life can be significant. Microscopic colitis affects 0.12% of the population but 12.80% of those with unexplained chronic, watery diarrhoea. The median age at diagnosis is 60,2 reflecting an older population than those typically diagnosed with other types of inflammatory bowel disease. Risk factors include smoking and long-term use of proton-pump inhibitors, non-steroidal anti-inflammatory drugs, and selective serotonin reuptake inhibitors, although a causal relationship has not been established.2 The most common symptom in microscopic colitis is chronic, non-bloody, watery, diarrhoea, frequently associated with faecal urgency, the passage of stools at night, and faecal incontinence. Cramping abdominal pain may be present. These symptoms can be severe enough to make patients effectively housebound. Patients may …